Schizophrenia Somewhat Simplified

December 20, 2010

Having been a practicing mental health professional and supervisor of other therapists for many years, I have come to believe that if I cannot explain a psychiatric condition in terms my grandmother would have understood without resorting to professional jargon, I may not really understand what I am talking about. Here is a more formal and then a more vernacular explanation of the disorder we call Schizophrenia.

Schizophrenia is a serious mental disorder characterized, primarily, by distortions in thought.

It can be difficult for a person who has 1) never experienced visual or auditory hallucinations (seeing or hearing things that are not ‘˜really’ there,) 2) had delusional ideas (notions and beliefs that are not related to more clearly and accurately perceived reality,) 3) struggled with the inability to formulate and express coherent thoughts, 4) control one’s behavior or 5) escape from a state of catatonia (the inability to speak, move or act for reasons not explainable due to strictly physical limitations) to fully appreciate just how catastrophically debilitating Schizophrenia can be. The symptoms may manifest in a variety of ways and any one of the five mentioned above can be a sign of the thought disorder we call Schizophrenia.

For the diagnosis to be seriously considered, at least one of those symptoms must have been present for at least six months if untreated, create significant problems for the person’s functioning both socially and occupationally and not be attributable to substance use, another general medical condition or developmental disability.

There are five basic categories of Schizophrenia, each characterized by the primary symptom. These include 1) The Paranoid Type, 2) The Disorganized Type, 3) The Catatonic Type, 4) an “Undifferentiated” Type and what is referred to as 5) The Residual Type.

Schizophrenia can be a frightening experience. Not being able to control one’s own thinking and having other people tell you (or suggest) that what you see and hear is not “real” can be incredibly but understandably unsettling.

If you know someone with this disorder, it is very important to remember (as any appropriately trained professional knows) that a person with the disorder has not ceased being a person and become a schizophrenic. Rather, the person is an individual who suffers from Schizophrenia. It is not what the person is; it is the name of a disorder they have. To forget this is to reduce a human being to an illness. The act is either simply uninformed, insensitive or, at very worse, cruel.

In each situation, there is believed to be a biological component. This often takes the form of a biogenetic (often inherited) physical vulnerability toward developing this disorder and treatment. More often than not, includes some psychoactive medication to help people be better able to control their own thinking.

People with serious mental disorders sometimes stop taking their medications either because they don’t like some of the side-effects (many anti-psychotic and anti-depressant medicines, for example, can cause weight gain) or because the medicines have worked for a while, causing the person to believe that s/he no longer needs them. The risk, of course, is that while medicines may help, withdrawing them can cause a person to fall back to the condition they were in before beginning to take them.

In any event, people suffering from thought disorders like Schizophrenia need professional help. They may not always be willing to accept it and because the disorder distorts a person’s ability to reason logically, the person my really believe that they are OK and that the problem is everyone else.

So long is no one is being hurt or in danger of being hurt, most states allow any adult to refuse treatment no matter how clear the need may seem to others. In a Democracy (or, more precisely, a Democratic Republic) people are entitled to make poor decisions on their own behalf.

Some people refer to this as the “Right to Folly.” When it comes to a serious mental illness it may actually endanger a person and/or those around them to not receive needed treatment. We struggle on with the issue of individual rights vs. the judgment of others. Not just for people with Schizophrenia, but for all of us.

In extreme situations, individual States provide Health and Welfare Codes that make provision for the involuntary hospitalization of a person assessed to be at immediate risk of causing injury to themselves or others (or being unable to attend to their own basic needs) on the basis of a mental disorder. In California, this is generally referred to by the Code number “5150” but is always the exception and not, if properly employed, the.

People with mental illnesses, including those suffering from schizophrenia, have an illness … and civil rights, too.